{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T12:00:09Z","timestamp":1791979209407,"version":"4.4.0"},"reference-count":18,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2010,4,20]],"date-time":"2010-04-20T00:00:00Z","timestamp":1271721600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2010,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives\/Hypothesis:<\/jats:title><jats:p>Repair of the skull base still begins with a direct repair of the dural defect. We present a new button closure for primary repair of the dura for high flow defects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design:<\/jats:title><jats:p>Retrospective review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p>We reviewed our 20 cases of primary button grafts and compared the results to the previous 20 high\u2010flow open\u2010cistern cerebrospinal fluid (CSF) cases. Subjects were excluded if they had no violation of the arachnoid space or potential for low\u2010flow CSF leak. The button is constructed so that the inlay portion is at least 25% larger than the dural defect, and the onlay portion is just large enough to cover the dural defect. The two grafts are sutured together using two 4\u20100 Neurolon sutures and placed with the inlay portion intradurally and the onlay portion extradurally.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p>The button graft repair of open\u2010cisternal defects had a drop in CSF leak complications to 10% (2\/20), and these two leaks were repaired with the button technique as the salvage surgery. This is a significant improvement over the 45% leak rate in the prebutton graft group (<jats:italic>P<\/jats:italic> &lt; .03). In our button graft group we used nasoseptal flaps on 16\/20 repairs, and 1\/2 repairs that leaked in the button group did not have a nasoseptal flap. Lumbar drains were used in \u223c38% in both groups (<jats:italic>P<\/jats:italic> = .83).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions:<\/jats:title><jats:p>The button graft can be used in conjunction with the nasal septal flap or as a stand\u2010alone repair with good results reducing the postoperative leak rate to 10% for high\u2010flow CSF repairs. Laryngoscope, 2010<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.20861","type":"journal-article","created":{"date-parts":[[2010,4,20]],"date-time":"2010-04-20T18:54:08Z","timestamp":1271789648000},"page":"876-880","source":"Crossref","is-referenced-by-count":136,"title":["Endoscopic repair of high\u2010flow cranial base defects using a bilayer button"],"prefix":"10.1002","volume":"120","author":[{"given":"Adam J.","family":"Luginbuhl","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter G.","family":"Campbell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Evans","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Rosen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2010,4,21]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1926.01130050003001"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1952.00710020018001"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/MLG.0b013e3180471482"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000234933.37779.e4"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.3171\/foc.2005.19.1.9"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.3171\/jns.2000.93.5.0762"},{"key":"e_1_2_6_8_2","first-page":"7","article-title":"Endonasal endoscopic repair of ethmoid roof cerebral fluid fistula by suturing the dura","volume":"10","author":"Cukurova I","year":"2008","journal-title":"Acta Neurochir"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1227\/01.neu.0000326017.84315.1f"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2006.08.009"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200007000-00019"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006123-200108000-00042"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.3171\/JNS-07\/10\/0713"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1999.91.6.1055"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1998.88.6.0949"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-199006000-00011"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/mlg.0b013e318062111f"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000297074.13423.F5"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.2500\/ajra.2009.23.3378"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flary.20861","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.20861","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T08:11:01Z","timestamp":1696925461000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.20861"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,4,21]]},"references-count":18,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2010,5]]}},"alternative-id":["10.1002\/lary.20861"],"URL":"https:\/\/doi.org\/10.1002\/lary.20861","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,4,21]]}}}